Discovery Health Medical Aid
Reviews and Complaints

On 1st June 2018 I contacted discovery call centre to enquire about re-instating medical to my own bank account. I had left employment from my company on 31 May 2018 and would be starting at new company on 1 July 2018. I therefore wanted to ensure I was covered even though I was not going to be getting a salary.

I specifically advised the consultant that I would be moving to a new company in July and would therefore want to be on a cheaper plan only for the month of June.
I sent the change in banking details and received confirmation of re-instatement on 15 June but billed from 1st of June.

In July I was billed for the full amount and my medical aid suspended while Discover awaited payment.
In the background on June 18th I sent documentation to new employer to transfer my medical aid to the new employer. This form gave the option to change to a new plan, please note, at NO POINT did any Discovery consultant inform me that I could not move to a better plan. Had I know this I would not have taken cover in June as the employer guarantees no waiting period when restarting.

I now on 10 July 2018 am trying to confirm my medical aid status and have been informed that I cannot change plans up. This is completely frustrating as I am now in a worse off position and only because I wanted to make sure I had cover for one month. So Discovery was only happy to benefit at my expense - take the full months premium even though cover was only from the 15th of June to 30 June.

If I cannot get back onto the plan I was intending to, I want to be refunded for the portion of the month where I was not covered, clearly it was the worst decision.

My Name: Pierre Louw
Cell: [protected]
Desirable Outcome: Discovery to pay the money owing to me

I received a email on the 4th of April 2018 that Discovery owes me R2207.58 from healthy living cashback. They stated that I needed to update my banking details to receive the cash, as my banking details were outdated. I then proceeded to update my banking details online. After a couple of weeks I realised that the money has still not been paid into my bank account so I phoned the vitality line. I spoke to a lady and she assured me that the money will be paid by the 28th of the month, as their payroll closes on that day. This did not happen, so I phoned Discovery vitality on the 2 July 2018 to sort this out and another lady told me to hold on so that she can verify some accounts info. I proceeded to hold for 15min and then decided to drop the call, after she never came back to me. Please refer to email below.

Dear Mr Louw

You have Vitality HealthyLiving cash back due to you

We are unable to pay your Vitality HealthyLiving cash back because the payment details we have on record for you are outdated.

The cash back amount currently due to you is R2207.58

Please update your cash back payment details to have your cash backs paid directly into your bank account by following these steps:

To update your details, follow these steps:

Log into your Discovery profile on www.discovery.co.za
Click on ‘Vitality', and under the ‘Reward Partners' page, select ‘HealthyFood at Pick n Pay and Woolworths'
Select "Learn more" option
Select ‘Change cash back account details
Enter your OTP (One Time Password)
Update your banking details, and then click ‘Continue'
Alternatively, to update your details using the attached form, please follow these steps:

Log into www.discovery.co.za
Select Vitality and then scroll down to ‘Help' and complete all the fields under ‘Send a query to Vitality'
Complete and then upload the attached form and submit with a copy of your ID and a recent bank statement.

For any queries visit our online support page: www.discovery.co.za > Vitality > Help and "Send a query". For any general product and information related questions why not Ask Discovery on our home page. This interactive platform is designed to help you with every day questions about Discovery's products, processes and services. View a detailed breakdown of the points you have earned on the Vitality Points Monitor, and track your gym visits on the Gym Tracker on the gym, devices and fitness page.

Regards

Palesa Goba

Discovery Vitality

This message and any attachments are confidential and intended solely for the addressee. If you have received this message in error, please notify Discovery immediately, telephone number +[protected]. Any unauthorised use; alteration or dissemination of the contents of this email is strictly prohibited. In no event will Discovery or the sender be liable in any manner whatsoever to any person for any loss or any direct, indirect, special or consequential damages arising from use of this email or any linked website, including, without limitation, from any lost profits, business interruption, loss of programmes or other data that may be stored on any information handling system or otherwise from any assurance that this email is virus free even if Discovery is expressly advised of the possibility of such damages. Discovery is an Authorised Financial Services Provider.

Banking details for your Discovery Vitality cash back benefits.pdf

I have tried now for 7 days to lodge a 3rd party claim. I have contacted [protected] to speak with Nanthantla regarding my claim however no response or a call back after leaving several messages with Nellie and Paulie... I even submitted 2 online quotes for vehicle insurance with call back but no response. Disvoveryinsure.. Your customer services is a joke... So much for a so called professional well known established company with no customer service etiquette...

I have been applying for my dependant since January without any luck this is getting frustrating as I now don't know what to do. Even yesterday I emailed my forms even today but the mailbox is full. Is that too much to ask for just to add a dependant?

I sent forms as an infant those were turned back I was told if my son is over 3months I cannot add him as an infant but as a dependant. I tried adding my son in January after I gave birth but failed as the forms didn't go through and I still tried but nothing seems to be going through.

How soon can I cancel my membership with discovery?

I was told by the surgeon to pay for medicine immediately, 1 week before an operation. This was required to process the order, and arrange delivery by the time of the operation.

I paid immediately after I received the invoice from the hospital's pharmacy.
On 13 april 2018, I was admitted to life glynnwood hospital and I received the medicine in hospital, in the ward, from a nurse, after being admitted, and por the purpose of the operation.

The operation was pre-authorised by discovery, and I have unlimited in hospital cover, so there was no reason to think that I would not be refunded later on, which was why I paid.

Both the dr's assistant and myself submitted a claim to discovery for a refund to be processed.
After it was declined, I sent the supporting documentation again, detailing the events. Even then, the claim was declined again.

Later, I was told via email that it was declined because of the sequence of events. The hospital did not invoice discovery for the medicine as part of the procedure. They were not willing to change their records.

The pharmacy invoiced me before the date of the operation, and should apparently have invoiced the hospital, and not myself...

Discovery rejected the claim based on the sequence of events.

It has been escalated, and has been under review since the 11th of june.

I have to say that r24 000 is not a small amount, putting me in debt, which I have to pay off over a few months...

However, discovery is this impenetrable corporate company, hiding behind call centres, so I can't get hold of anybody directly...

Member no: [protected]

Ref no's:
25/5: 5788882025
30/5: 5791692562
4/6: 5792646434
6/6: 5803468153
12/6: 5800821561
20/6: 5827404088

Good day Zainub,

I have been informed by my sister that she received an email from you regarding a non-payment of R3156-00 on my parents Medical Aid.

Please can you contact me regarding this as we tried to do the EFT but
would not take the Account no. My sister went to the Bank but they also
cannot help her .

Please contact me on [protected] or my cell [protected] .
You can use this Email or my work Email : [protected]@linksfieldemergency.co.za
I work at the Netcare Linksfield Hospital Emergency Unit in Johannesburg .
I have also requested a 3rd Party form from Discovery - Roxine -this morning to act on behalf of my parents and will forward to you as soon as
I have received it from Discovery.
My Parents gave their Concent via Telephone this morning to Roxine from Discovery.

We would really appreciate your help as my parents is incapable of sorting this out on their own, my Father suffers from a very progressive stage of Alzheimers and
my Mother is blind and cannot phone or write.

Kind Regards
Charmaine Monteiro (Daughter)

In March 2018 I informed Discovery that I had resigned from my job and would move my medical aid to private cover as it was subsidized by the company.

I also requested that I be removed from the cover and only my wife and child to continue. Discovery sent me all the relevant forms which I filled out and submitted.

I informed Discovery that my participation must terminate at the end of March and the cover for my wife and child would be deducted from my bank account.

All of this was done well within time however Discovery messed up and still charged me as a member of the cover.
I contacted Discovery and informed them of the mixup and that I had emigrated from SA. They asked for proof of my emigration, which I duly provided.
Now Discovery say they are going to review my request and I will be charged for May as well.

This is utter madness and daylight robbery.
I submitted all the required documentation and proof long ago and Discovery are just trying to continue ripping off.
They have already charged a full cover for April which should not even be the case as I had already submitted all the paper work and informed them telephonically as well.

I demand a refund for my portion of the April charge and also that Discovery stop ripping me off.
I also want to terminate the cover with Discovery completely as I don't trust these frauds.

Now I have to jump through hoops, do cartwheels, murder a leprechaun and bottle a rainbow just to get it cancelled and even then they will still keep charging me because, hey, who cares about cancellations when you can steal peoples money?

I am sick of all these corrupt South African businesses that are predicated on innumerable clauses, terms and conditions which are intricately designed to trap the unsuspecting citizen into the most heinous and soul destroying circumstances imaginable.

From Discovery with its subversively innocuous money pilfering tactics to insurance companies that fleece innocent people with their convenient loopholes and narcissistic disdain for other human beings, to the innumerable other artfully designed fronts which camouflage criminalistic and autocratic organisations.

We as the tax paying, law abiding and evident minority need to do something about this. But the question is, what?

Good day,

I have a question with regards to the costs / charges by our GP.
I need to know if it is permitted / allowed & what I can do about it if its not.

Before, when I was on Key Care Plus, my GP visits were charged at around R250 - R300, whether for myself or my daughter.
Now, since I have switched to Coastal Saver, my GP is charging me much, much higher rates, up to almost R500 per visit - for the same type of average visit, with nothing special.

Why do the GP's take advantage of my medical aid policy in this way?
At this rate, my entire savings will be completely depleted before this year is out.

What are my options and rights here?

Regards
Candice Rensburg

Good day,

I have been having issues with my discovery claims process since march,

Since march 2018 I have been using my maternity benefits and have been paying the gynae cash and claiming from discovery by submitting the invoices and receipts and have not been reimbursed not once.

I have called numerous times to speak to over 10 consultants and they are all untrained and just speak lies,
The most frustrating part is that they tell me that I will be paid and I just need to be patient,
Every consultant as advised that there is no turn around time!,

How is a huge company like discovery operating with no turn around time?

All I want is my money back.

I would like this to be sorted out asap or I will be changing service providers.

As Service Providers, we are (with the use of a password provided by yourselves)able to Validate membership when dealing with your clients at our health establishment. Of HUGE use has been the quick ability to check if an upcoming treatment will be covered by the savings available.
With your recent re-vamp of this service, that USEFUL tool has been abolished, replaced instead by us needing to raise a mock invoice to assess whether there are funds to cover. At my stage of using this Service, I do not have access to ICD10 codes, nor Practice Number of Drs, nor Feeing code, and so I am unable to assess (and assist) your client/my patient, regarding payment method. The upgrade requires me to enter these details.
Please revert back to, or allow as well as, the ability to merely check balance to cover a procedure. This is also VITALLY useful when YOUR webpage is slow in processing, and I can quickly get onto the site to decide whether the procedure will be covered, and hence allow the patient to leave, BEFORE you have responded.
Regards...JILL DEARMAN

I phoned Discovery Health for pre-authorization on 19/04/2018, speaking to Anina Kellermann. All information regarding ICD-10 codes as well as the location and doctor was given. She assured me everything would be covered and that only the discharge medicine would be for my account. A week after the procedure they are now not covering the clinic account. I have been given the runaround by their call centre and there is no way to contact management. They acknowledged that there was an issue, suggested ways to sort it out, but no progress or attempt to help.

Hi I took my son to the hospital in February but my medical aid was one month behind had to pay cash coz the receptionist said can't take my son home without paying so I paid a fee of R3005 witch I only got R1450 back I think you guys don't give any service and I will put this up every where coz I asked they said if I pay they will pay me my money back my one instalment was R1750 why did I have to pay so mutch if I just had to pay R1750 for medical aid... I paid all my medical aid that was behind just to get half my money back I would rather want my R5500 back whitch I pad to you guys and go to other medical aid if this can't get sorted
Thank you [protected]

My wife's car went to panel beaters of discovery's choice, after received the car (02/02/2018) we drove 3 km and then got stuck (engine seized)
We also found a tool that they use to remove body panels in engine compartment

1. After numerous complaints to Renew It Sandton they just said it is not their fault. Discovery also not willing to assist. We also picked up some bad workmanship on the repairs which we addressed with discovery and Renew It. No one replied to us not mail not telephonic.. We spend R 15 000 to get car fixed. The car was in Perfectly mechanical condition as Renew It drove it to Corbett drive for wheel alignment.
2. We had car hire on our policy. After we received our Broken car, Cleopatra from Discovery extended the car rental for 3 days. Avis did not pick it up on their system and we had to pay that also. Up to today (13/03/2018) Cleopatra nor her line leader Roland responded to us for the refund. Kenton le Roux also promised to contact me regarding the complaints about the bad workmanship

Good Day

I am extremely disappointed with your systems that you have in place.
Always commended Discovery South Africa for being outstanding, but this just makes me wonder.
I applied for a Discovery credit card, they asked me to submit my 3 months bank statement, i did. I am still waiting for the past month for a response, being pushed around from pillar to post.
Its fine if Discovery cannot supply me with a credit card, FNB has already supplied me with one to the value of R143000.
The part is were I am disturbed is that I changed my Surname some 10 years ago. From Ramruthan to Manilall. On my it34, Sars still has me registered as Ramruthan.
Discovery asked me for my 2 Id docs.
The ID number and Tax numbers are the same.
To my surprise, after suplying these docs, my medical aid, my life policies are all changed to Ramruthan.
I never requested this, i never signed anything pertaining to the change in surname,
and at inception the policies are all under the name of Manilall and documents are all signed by the name of Manilall.
God forbid i dont need to use my medical aid in an emergency and this mess up comes about.
Please ammend this at once.
Please let me have your urgent response as i need to know what steps to take.

Date: 07/12/2017
Client No: [protected]
Client: Robyn Speelman
Title: Customer Service Resolution Specialist

Description:
I was contacted by Virgin Active Vitality and asked to re-join the group as I was a member since 1998 by Saaed. We discussed telephonically that they would offer me a service at a rate of R 117.50 pm when he initially made contact with me in September 28, 2017, provided I visit the gym before end of September (3 days) at least 7 times. I told him this is a little unreasonable at the time as we are left with 3 /4 days. He was supposed to provide me with an email stating the t's and c's but never did so as they had problems with their system. He never made contact with me ever again, and I tried calling him, to no avail. The matter was then escalated to Jason Jonathan and Dave Luis. Dave Luis assisted me and I was only granted access in the middle of October, and debited with and amount of R 117.50. I informed them that I have joined Planet Fitness, as I was not at all satisfied with the service level of VA and also waited for an emailing stating the t's and c's. Never received to date. On 1 December 2017 I was debited with an amount of R 237.50 an no one informed me prior to this why this would be the case. I made contact with Jason and David, and was asked by Jason for a paper trail as he did not have any. Robyn Speelman (Customer Service Resolution Specialist) then sent me a very arrogant email stating that I did not abide by the amount of club visits as set out in their t's & c's (which i to date never received), and therefore they have increased my monthly debit order (without notice) with R 120.00 at random which is the rate of a National Contract I had in place previously. Her approach and service is appalling for someone in her capacity and they are in breach of their agreement by not providing me with info at hand before the time, stating what the t's and c's are/were at the time. VA has changed there attitude and has no customer service level whatsoever. David who was the only one who assisted me at the time, has subsequently resigned. The staff turnover in VA is another problem, as you never end up speaking to the same person. Robyn called on Friday and left a snotty voice message and to which I will not even respond as I do not wish to speak to someone on that level. My problem is; I have had mayor concerns with VA (racist, service etc.) in the past and they obviously are not willing to improve on this service levels. I need a resolution on the way forward as I will not be dictated to by VA in terms of how many times I should visit the club when I am currently a member of Planet Fitness due to their arrogance and attitude until such time as they (VA) can prove to me that their service level has improved. I have lodged a complaint with Discovery Vitality informing them to review the status of membership on board level and to remove the VA Group from their system as they are damaging the Discovery brand. No matter who or where you complain to no one (social media, email, customer service level) at VA takes anything seriously and you keep on being passed from one arrogant staff member to another. At Planet Fitness, it is a breeze to excersize as the staff are friendly, the music is decent, and they treat you like a human being & client. Which is what it should be like when you go to gym. You should not be stopped at the front door, denied access, be yelled at by a jnr staff member in front of other staff and members as if you are a minor or entering illegally. The VA group and its staff is over-rated, and they are extremely arrogant in their way and should be removed from Discovery Vitality in its totality. Being a member of the group since 1998 to date has changed (for the worst) on every single facet. As a Director of my own companies, I never treat any of my clients the way I have been treated by the VA Group and the staff on ALL levels.

I note with concern that my insurance premium and excess has been increased due to the large number/value of claims by Discovery Health.

Why I should be penalised for re-work on Discovery's Contractors part? If you look at the claims listing attached with my comments, numerous claims had to be repeated due to the original problem not being sufficiently addressed by the contractors Discovery selected and Discovery still going ahead and approving these contractors' payments irrespective of the concerns/complaints raised by the policy holder? Had your contractors done a good job to begin with, there would be need for further claims/re-work! Just this month I was still arguing with Discovery over re-selecting Manduko Contractors for a new claim after I had submitted several complaints about them previously and tried to escalate it? Discovery in fact indicated to me that the concerns around this contractor had been escalated to the Procurement Committee and Manduko Construction had since been stuck off your preferred supplier list? Do you make it a habit of lying to your clients? The fact that Discovery does not act against sub-standard workmanship, choosing to rather pay for poor quality and not hold contractors to warranty for quality repairs and then penalise their clients for excessive claims instead is questionable and not ethical.
When I submitted a claim for leaking pipes last month, Discovery sent out a contractor to perform a leak detection test and they reported no leaks (and were paid for it). Upon my own persistent digging in the yard, a few days later, I found a major leak (in a Main Water Pipe) and then had to submit yet another claim? Again, no repercussions to the respective contractor and multiple claim values added to my claims history.

When does Discovery own up to their own mistakes at using sub-standard contractors and not enforcing repercussions on these contractors for re-work instead of severely affecting client's claims history and then penalising them for it?

Furthermore, the Discovery complaints process is futile. I have submitted multiple complaints on the above matter and none have been addressed to date.

All I desire is an urgent response to this complaint and request that my claims history to be corrected to accurately reflect the basis of claims submitted.

Hai I'm patient from Durban in Pinetown I went to Docter P.S Sthole this year for consultation and I needed spectacles, but she offers me money she told me that she is going to do the eye test and process a claim.
If it approved she will give me call to come and collect my money, she claimed the amount of R5000 and she gave me R2200 cash!
She is in Crompton street Pinetown
Practise no 0502154
Tel [protected]

I visited my doctor in Eldorado Park on the 2nd Sept 2017
He examined my non stop coughing then advised I have Asthma
I was then provided with a script for Asthma pumps, nasal spray an Aspen Vortex spacer

Made contact with Discovery health to confirm if the medication was approved under chronic.The consultant at the Chronic department advised it was approved I may collect the medication at any Clicks or Dis-chem Pharmacies

On the 9th Sept 2017 I visited the Clicks(Chili Lane) in Sunninghill stood there almost 30mins before being assisted, only to find the Dispenser entered my medical aid details then told me the medication is not listed under as Chronic I need to pay cash to which is not fair as even my doctor confirmed the meds as listed will be placed on Chronic, therefore I will not be charged.I would like this issue resolved immediately as this is unproffessional and I am not well

Please see attached photo will inital story.
I did eventually get an authorisation number but now the Medical aid scheme says they do not cover everything in hospital and I am stuck with Bills from Radiology, the anaesthetist and even the surgeon yet they are all in the hospital thet my dad is in which is on Discovery's network as well as the surgeon has a payment plan with them. I have called them over 20 times this week and spent around 20-30 hours on the phone with them. Why am i paying R5000 a month for a medical aid that does not cover my folks.

Hi,

Today we had a huge problem which now cost us R9000. My mum who has a
Key care and gap cover got sick at home and so while deciding which hospitals we can go to we call the number on the back of her card and asked the consultant to check if her medical aid is open to use as this was the first time using it. We also asked her to advise us on which hospitals we can go to so she asked us for the member number we gave it to her she checked and said its fine we can use it and she told us which hospital to ho to. So we rushed mum she was taken to truma then a ct scan and other stuff was done. At the hospital there was a discovery representative( Vanessa) now when we got there we said mum might be having a stroke as she has had one in the before. So this Vanessa send through the auth say "stroke" without confirming it, at that time discovery declined the auth as there is a waiting period for passed sickness. The doctor then sends mum for a ct scan and when that results came it show no signs of stroke it only picked on the old one. Now this Vanessa send a new auth for a seizure. And it it was declined as well. Now this was a new sickness as mum never had it before. Now we are extremely disappointed with the service received from both the call center and Vanessa if we got the correct information from the call center we would have never went to a private hospital and I have the call that we made to the call center RECORDED, and Vanessa at the hospital was very unprofessional and during at time like that with us been stressed you need someone whos more will to assist and not jump the gun.

Now we are sitting with huge bills that needs to be paid and I feel that discovery she be held accountable for it and we got wrong information from you guys. Mum also has a gap cover so maybe look at using it for the payments.

Please treat this with the up most urgency as I will allow this matter to slide by.

Looking forward to hearing back

Regards,

Siven Naidoo
[protected]
[protected]